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目的:观察蛋白强化的EN对肥胖的急性胰腺炎(AP)病人体脂分布和蛋白质代谢的影响。方法:选择符合AP标准,体质量指数(BMI)≥26 kg/m2的病人,前瞻、随机分为对照组(24例)和试验组(29例)。分别应用蛋白强化EN和标准EN。记录病人体质量、BMI的变化;测量脂肪群、腹部脂肪比率、肌肉群和蛋白质等指标的改变;检测总蛋白(TP)、ALB、PA、纤维连接蛋白(FN)、TF的变化。结果:两组病人在EN支持后,体质量、BMI、脂肪群和腹部脂肪比率较营养支持前有所下降,并且试验组下降明显。血清蛋白质较营养支持前均有升高,达到正常水平,试验组病人的PA和FN增加明显。结论:蛋白强化的EN不仅能改善AP病人的肥胖和脂肪分布异常,而且还能减轻并发症,改善预后。
AIM: To investigate the effect of protein-enhanced EN on body fat distribution and protein metabolism in obese acute pancreatitis (AP) patients. Methods: Patients who met AP criteria and had body mass index (BMI) ≥26 kg / m2 were prospectively and randomly divided into control group (24 cases) and experimental group (29 cases). Apply protein fortification EN and standard EN respectively. The changes of body mass and BMI were recorded. The changes of fat mass, abdominal fat ratio, muscle mass and protein were measured. The changes of total protein (TP), ALB, PA, fibronectin and TF were measured. Results: After EN support, body mass, BMI, fat mass and abdominal fat ratio decreased compared with those before nutritional support in both groups, and the test group decreased significantly. Serum protein was higher than before nutritional support, reaching the normal level, PA and FN increased significantly in the test group of patients. CONCLUSIONS: Protein-fortified EN not only improves the obesity and fat distribution abnormalities in AP patients, but also reduces complications and improves prognosis.